Americans don’t know how to feel about eased Covid rules

Mar 01, 2022

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With Katherine Ellen Foley and Alice Miranda Ollstein

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QUICK FIX

— A new poll illustrates Americans' divides — even within themselves — over returning to normal as coronavirus cases decline.

— Biden unveils sweeping nursing home initiatives to counter widespread problems exacerbated by the pandemic.

— What's the SOTU audience going to look like? Masks can be off, but will they be?

WELCOME TO TUESDAY PULSE — Ahead of tonight's State of the Union, Eugene Daniels wrote about the craziest SOTU to date . Send good reads, SOTU memories and tips to sowermohle@politico.com.

A message from PhRMA:

From out-of-pocket costs, to deductibles, to hospital bills – the most vulnerable patients face challenges. 3 in 10 Americans who have insurance still face a financial barrier to care. We need to make the cost of medicine more predictable and affordable. Learn more.

Driving the Day

AMERICANS DIVIDED OVER EVOLVING COVID RULES — Many Americans are ready to return to some sense of normal but worried about the pitfalls of moving too fast, according to Kaiser Family Foundation's latest Vaccine Monitor survey, out this morning.

The highlights:

— Sixty-one percent of people say lifting rules like mask mandates that would put people who are immunocompromised at risk has them feeling stressed.

— But while nervous about rolling back restrictions, most respondents (65 percent) say they worry more about what keeping them will do to children's mental health, followed by 63 percent worried about local businesses.

— Hospitalization and death — especially case rates that overwhelm hospitals — are still a concern for nearly half of respondents.

But partisan divides show. Democrats are far more likely than Republicans to worry about the impact on people with weak immune systems and their communities, with 82 percent of Democrats concerned about their risk amid eased restrictions compared with 30 percent of Republicans.

Meanwhile, 73 percent of Republicans say they worry about children's mental health if restrictions aren't lifted, compared with 56 percent of Democrats, similar to figures for concern about local businesses.

"The conventional wisdom seems to be that Americans are ready to throw off all Covid restrictions and be done with it, but the survey shows that reality is much more complicated," KFF President and CEO Drew Altman said in a statement. "Much of the public is sensibly both anxious and eager about returning to normal."

And parents are confused about kids' shots. Fifty-seven percent of parents with children under 5 say they need more information about Covid-19 vaccines in that age range before vaccinating their kids. After Pfizer and the FDA delayed the shots' expected launch date, roughly two-thirds of those parents say they aren't confident that the vaccines are safe for their young children.

KFF's latest survey was conducted between Feb. 9–21 among 1,502 adults nationwide.

BIDEN LAUNCHES NURSING HOME SAFETY PLAN — The White House on Monday announced wide-ranging initiatives it says will make nursing homes around the country safer after Covid-19 ravaged the facilities, POLITICO's Rachael Levy reports.

The range of initiatives that the administration said would ensure residents are better cared for land right before Biden's State of the Union address.

The changes include a proposed minimum staffing requirement and a reduced number of residents housed in the same rooms. Biden will also ask Congress to provide nearly $500 million to the federal Medicare administrator, a 25 percent increase, to boost health and safety inspections. (That funding has remained flat for seven years, the White House said.)

The administration also proposed a new public database that would identify nursing home operators and previous safety issues and said it would increase fines at poorly operated nursing homes from $21,000 to $1 million.

Background: The pandemic laid bare insufficient safety measures at many facilities, where infections spread rapidly before vaccinations became widely available and residents continued to die at higher rates afterward, Rachael notes. More than 200,000 residents and staff have died from Covid-19 so far, representing nearly a quarter of all Covid-19 deaths in the U.S., the administration said.

THE COVID STANCES AT SOTU — Lawmakers convene tonight for the first mass in-person event in two years where they could all technically be unmasked after the attending physician rolled back the requirement on Sunday, citing low rates among Capitol workers and the CDC's changed guidance.

That doesn't mean they all will be. Alice tells Pulse that many lawmakers, particularly Democrats, were still masked up during votes Monday. Transmission is still high in many parts of the country, and most lawmakers are traveling back and forth to their districts (plus many are above age 65).

Continuing to mask indoors with hundreds of people sends a clear message: This pandemic isn't over. It's a message President Joe Biden himself is expected to underscore tonight even as he touts falling case rates and expresses optimism for the road ahead.

On the other hand, some Republicans are already positioning themselves against other public health rules. Sen. Marco Rubio (R-Fla.) said Monday he wouldn't attend the speech because of its testing requirement, telling HuffPost's Igor Bobic, "I don't have time to go take a COVID test today. I only take a test if I'm sick."

Speaking of SOTU: Join me and other POLITICO reporters for a live annotation of the speech tonight where we'll cover a range of topics from Covid-19 and drug costs to Ukraine and congressional priorities.

A message from PhRMA:

In Congress

PROVIDERS, INSURERS PRESS TO KEEP MEDICARE SEQUESTER PAUSE — Fifty major provider, patient and payer groups wrote to congressional leaders Monday, calling on them to extend a 2 percent Medicare sequester moratorium until the end of the public health emergency.

Pausing the payment change "has provided critical relief in our ongoing battle," wrote groups that included the Federation of American Hospitals, American Medical Association, Blue Cross Blue Shield and Better Medicare Alliance. "While we are encouraged that the worst days of the Omicron variant are hopefully behind us, it is also abundantly clear that daily COVID infection rates, hospitalizations, and deaths remain exceedingly high."

Remember: The PHE runs out in less than two months, but HHS promised to alert providers 60 days ahead of ending the emergency — so it will continue at least through July.

DEMOCRATS LOSE ABORTION VOTE, VOW REBOOT — The Senate on Monday night failed to advance the Women's Health Protection Act, their signature bill to protect abortion rights, after Sen. Joe Manchin (D-W.Va.) joined all Republicans present in voting no, Alice reports.

Democrats didn't have a clear answer Monday on what they'll do to shore up abortion protections other than push the issue in the November midterms.

The vote highlighted how few lawmakers cross party lines on abortion anymore, Alice notes. Sen. Susan Collins (R-Maine) and Sen. Lisa Murkowski (R-Alaska) released a competing bill that would offer narrower protections for abortion rights before voting no on the Democrats' version. Sen. Tim Kaine (D-Va.) voted yes but released a statement stressing he personally opposes abortion and wants to maintain a federal ban on abortion funding.

Industry Intel

FIRST IN PULSE: REDUCED NICOTINE CIGARETTES COMING TO MARKET — The only modified-risk cigarettes currently cleared for sale in the U.S. will hit Chicago markets this month, Katherine reports. In late 2021, the Food and Drug Administration authorized 22nd Century Group to advertise its VLN King and VLN Menthol King cigarettes as containing "95 percent less nicotine," which will help "reduce nicotine consumption."

Background: The Food and Drug Administration has only given two other tobacco products the "modified-risk" clearance. The first is a smokeless tobacco pouch from Swedish Match USA; the second is the IQOS cigarette, a heated tobacco product from Philip Morris International. However, a patent dispute with British American Tobacco resulted in the products being pulled from U.S. markets in 2021.

Names in the News

The Health and Human Services Department named Emeka Egwim director of the Office of Pharmacy Affairs at the Health Resources and Services Administration. He began working in OPA in 2011, focusing on the 340B drug safety program and patient-safety collaborations before serving as a pharmacist at the Centers for Medicare and Medicaid and later in active duty for the U.S. Public Health Service.

Jude McCartin has been tapped as chief of staff for Families USA. She previously was associate director of federal governmental relations in the office of the president at the University of California and worked for Sens. Maggie Hassan (D-N.H.), Martin Heinrich (D-N.M.) and Jeff Bingaman.

What We're Reading

Widespread hospital consolidation in New York City has fueled provider megasystems concentrated in whiter, wealthier areas while nearly two dozen hospitals have closed in other parts of the city, losing thousands of beds, Maya Kaufman and Amanda Glodowski report for Crain's New York.

The U.S. Patent and Trademark Office ruled on Monday that claims over who invented CRISPR belong to the Broad Institute of MIT and Harvard , dealing a massive blow to University of California scientists who worked on early versions of the genome editing technology, Stat News' Megan Molteni reports.

Climate change is outpacing measures to curb its dangers, the Intergovernmental Panel on Climate Change said in a report warning there's "a brief and rapidly closing window " to stem it, The New York Times' Brad Plumer and Raymond Zhong report.

A message from PhRMA:

The most vulnerable patients face challenges.

3 in 10 Americans who have insurance still face a financial barrier to care.

We need to make the cost of medicine more predictable and affordable. Government price setting is the wrong way. The right way means covering more medicines from day one, making out-of-pocket costs more predictable and sharing negotiated savings with patients at the pharmacy counter.

Learn more.